Objective To explore the application value of different Trocar layouts in retroperitoneal laparoscopic partial nephrectomy for localized renal cell carcinoma, so as to provide reference for the layout of Trocar during operation. Methods The data of 137 patients with localized renal cell carcinoma who underwent retroperitoneal laparoscopic partial nephrectomy in our hospital during Sep. 2021 and Sep. 2024 were retrospectively collected, including 68 patients with umbrella layout(umbrella group)and 69 with trapezoidal layout(trapezoidal group). The operation-related indexes, renal function(glomerular filtration rate, serum creatinine), traumatic stress indexes including C-reactive protein(CRP), cortisol, and interleukin-6(IL-6), complications and recurrence rate were compared between the two groups. Results There were no significant differences in pathological results, negative rate of surgical margins, hospitalization time, complications, 1-year recurrence rate, 6-month glomerular filtration rate and serum creatinine between the two groups(P＞0.05). Compared with the trapezoidal group, the umbrella group had less intraoperative blood loss [(72.11±18.30)mL vs.(87.59±20.63)mL], shorter operation time [(88.15±16.92)min vs.(99.40±20.78)min], renal warm ischemia time [(14.68±4.60)vs.(19.27±6.11)min], bowel sound recovery time [(21.00±5.75)h vs.(25.78±4.89)h] and ambulation time [(1.72±0.48)d vs.(2.04±0.55)d](P＜0.05). The umbrella group had lower CRP [(10.02±2.78)mg/ L vs.(12.00±3.15)mg/ L] on the first day after surgery, lower CRP [(7.89±0.76)vs.(8.77±1.25)mg/L] on the third day after surgery, lower cortisol [(0.67±0.20)μmol/L vs.(0.89±0.28)μmol/L] on the first day after surgery, lower cortisol [(0.58±0.15)μmol/L vs.(0.69±0.12)μmol/L] on the third day after surgery, lower IL-6 [(28.20±6.74)ng/L vs.(35.16±7.30)ng/L] on the first day after surgery, and lower IL-6[(21.25±5.39)ng/L vs.(29.78±4.26)ng/L] on the third day after surgery(P＜0.05). Conclusion Compared with the trapezoidal Trocar layout, the umbrella Trocar layout for retroperitoneal laparoscopic partial nephrectomy in patients with localized renal cell carcinoma offers advantages such as minimal surgical trauma, shorter operation and renal warm ischemia time, and faster postoperative recovery.

BACKGROUND: The incidence and mortality rates of lung cancer remain on the rise, creating an urgent need for screening among high-risk populations and early prevention. This study aims to explore the association and interaction between multidimensional lifestyle, socioeconomic status, and the incidence of lung cancer, and to provide scientific evidence for screening high-risk populations and preventing lung cancer. METHODS: Healthy lifestyle score was constructed using information on smoking, alcohol consumption, exercise, diet and sleep obtained through a questionnaire survey. Socioeconomic status was evaluated based on information on education, employment, and family income, and genetic testing data were used to assess the risk of genetic variation. A proportional hazards assumption test was conducted, and the Cox proportional hazards model was applied to analyze the associations between healthy lifestyle scores, socioeconomic status, and lung cancer, as well as the interactions among various factors, after adjusting for the risk of genetic variation, age, gender, diabetes, hypertension and the living environment score. RESULTS: A total of 245,538 samples that entered the cohort from March, 2006 to October, 2010 were included and followed up until December 31, 2022. The participants were divided into the case group (n=1472) and the control group (n=244,066). The analysis results showed that after adjusting for covariates, there was still an association between the healthy lifestyle score, socioeconomic status, and the incidence of lung cancer: compared with participants with a high healthy lifestyle score, the risk of lung cancer in participants with medium and low healthy lifestyle scores was significantly increased, with hazard ratios (HR) of 2.12 (95%CI: 1.86-2.41) and 3.36 (95%CI: 2.82-3.99) respectively; compared with participants with high socioeconomic status, the risk of lung cancer in participants with medium and low socioeconomic status was significantly increased, with HR of 1.29 (95%CI: 1.13-1.48) and 1.67 (95%CI: 1.46-1.90) respectively. Moreover, there were interactions between smoking status and socioeconomic status (Pfor interaction=0.05), as well as the other four lifestyle factors (Pfor interaction=0.02). CONCLUSIONS This study identified the association between multidimensional lifestyle factors and socioeconomic status with the incidence of lung cancer, as well as interactions between smoking and socioeconomic status and four other lifestyle factors, providing a scientific basis for screening and prevention in high-risk populations for lung cancer.
Humans ; Lung Neoplasms/epidemiology* ; Male ; Female ; Middle Aged ; Incidence ; Life Style ; Social Class ; Aged ; Adult ; Risk Factors

Protein aggregation plays an essential role in the development of cataracts.In recent years,gene sequencing and other molecular biological techniques have been widely used in the study of protein aggregation,whose intrinsic mecha-nisms have been gradually elucidated.Gene mutations,isomerization and covalent modifications,compound and ionic in-teractions,and protein interactions are all causes of protein aggregation.This article focuses on the above four causes to review the research progress on the effect of protein aggregation in the development of cataracts,so as to provide informa-tion and reference for subsequent studies.

BACKGROUND: Measuring the health of the population is of great significance to the development of a region. We aimed to estimate the population, probability of death, and quality of life in western China. METHODS: We calculated the age-specific mortality rate and prevalence rate of diseases and injuries using the Full Population Database and the Home Page of Inpatient Medical Record. We used multiple interpolation methods to insert missing information from the death data and the model of Kannisto to adjust the mortality rate for elderly individuals. The age-specific prevalence rate of diseases and injuries was adjusted according to the standard ratio of age and methods of equal proportional allocation. Life expectancy was calculated by a life table, and the quality of life was estimated using the Sullivan method. RESULTS: The total population continued to increase in 2015 to 2019 in the Shaanxi Province, China. The mortality rate of children under five has improved, and the mortality rate of people over 65 is decreasing year by year. Life expectancy increased from 74.66 years in 2015 to 77.19 years in 2019. Even with the total risk of disease and injury, the health-adjusted life expectancy increased by 1.90 years within 5 years, and the number of unhealthy years significantly improved. Health-adjusted life expectancy increased by 1.75 years when only considered the ten major disease systems (tumors; endocrinology, nutrition and metabolism; mental and behavioral disorders; nervous system; sensory diseases; circulatory system; respiratory system; digestive system; genitourinary system; musculoskeletal system and connective tissue), and the number of unhealthy years increased slightly. CONCLUSIONS In the past five years, Shaanxi Province has made progress in improving life expectancy and controlling the development of chronic diseases. It is necessary to take specific preventive measures and improve the quality of basic public health services.
Child ; Humans ; Aged ; Cross-Sectional Studies ; Quality of Life ; Life Expectancy ; China/epidemiology* ; Prevalence

Objective:To develop a risk prediction model for the recurrence of diabetic foot ulcer (DFU) in diabetic patients and primarily validate its predictive value.Methods:Meta-analysis combined with retrospective cohort study was conducted. The Chinese and English papers on risk factors related to DFU recurrence publicly published in China Biology Medicine disc, China National Knowledge Infrastructure, Wanfang Database, VIP Database, and PubMed, Embase, Cochrane Library, and Web of Science, and the search time was from the establishment date of each database until March 31 st, 2022. The papers were screened and evaluated, the data were extracted, a meta-analysis was performed using RevMan 5.4.1 statistical software to screen risk factors for DFU recurrence, and Egger's linear regression was used to assess the publication bias of the study results. Risk factors for DFU recurrence mentioned in ≥3 studies and with statistically significant differences in the meta-analysis were selected as the independent variables to develop a logistic regression model for risk prediction of DFU recurrence. The medical records of 101 patients with DFU who met the inclusion criteria and were admitted to Affiliated Hospital of Guizhou Medical University from January 2019 to June 2022 were collected. There were 69 males and 32 females, aged (63±14) years. The receiver operating characteristic (ROC) curve of the predictive performance of the above constructed predictive model for DFU recurrence was drawn, and the area under the ROC curve, maximum Youden index, and sensitivity and specificity at the point were calculated. Dataset including data of 8 risk factors for DFU recurrence and the DFU recurrence rates of 10 000 cases was simulated using RStudio software and a scatter plot was drawn to determine two probabilities for risk division of DFU recurrence. Using the β coefficients corresponding to 8 DFU recurrence risk factors ×10 and taking the integer as the score of coefficient weight of each risk factor, the total score was obtained by summing up, and the cutoff scores for risk level division were calculated based on the total score × two probabilities for risk division of DFU recurrence. Results:Finally, 20 papers were included, including 3 case-control studies and 17 cohort studies, with a total of 4 238 cases and DFU recurrence rate of 22.7% to 71.2%. Meta-analysis showed that glycosylated hemoglobin >7.5% and with plantar ulcer, diabetic peripheral neuropathy, diabetic peripheral vascular disease, smoking, osteomyelitis, history of amputation/toe amputation, and multidrug-resistant bacterial infection were risk factors for the recurrence of DFU (with odds ratios of 3.27, 3.66, 4.05, 3.94, 1.98, 7.17, 11.96, 3.61, 95% confidence intervals of 2.79-3.84, 2.06-6.50, 2.50-6.58, 2.65-5.84, 1.65-2.38, 2.29-22.47, 4.60-31.14, 3.13-4.17, respectively, P<0.05). There were no statistically significant differences in publication biases of diabetic peripheral neuropathy, diabetic peripheral vascular disease, glycosylated hemoglobin >7.5%, plantar ulcer, smoking, multidrug-resistant bacterial infection, or osteomyelitis ( P>0.05), but there was a statistically significant difference in the publication bias of amputation/toe amputation ( t=-30.39, P<0.05). The area under the ROC curve of the predictive model was 0.81 (with 95% confidence interval of 0.71-0.91) and the maximum Youden index was 0.59, at which the sensitivity was 72% and the specificity was 86%. Ultimately, 29.0% and 44.8% were identified respectively as the cutoff for dividing the probability of low risk and medium risk, and medium risk and high risk for DFU recurrence, while the corresponding total scores of low, medium, and high risks of DFU recurrence were <37, 37-57, and 58-118, respectively. Conclusions:Eight risk factors for DFU recurrence are screened through meta-analysis and the risk prediction model for DFU recurrence is developed, which has moderate predictive accuracy and can provide guidance for healthcare workers to take interventions for patient with DFU recurrence risk.

Objective: To analyze the prevalence and changing trend of overweight and obesity among high school seniors in Beijing from 2009 to 2018, and to provide scientific basis for health and education departments to work out effective measures to prevent and control overweight and obesity among adolescents. Methods: The physical examination data of 700 588 high school seniors in Beijing from 2009 to 2018 were selected to describe the distribution characteristics of the detection rate of overweight and obesity, and to analyze whether there are differences in the prevalence of overweight and obesity among different genders and regions. Results: From 2009 to 2018, the prevalence rate of total overweight and obesity of high school seniors in Beijing showed an increasing trend by year ( χ 2=3.58, P <0.01). After 2016, the rising trend was more stable, and it declined for the first time in 2018. The prevalence of overweight ( χ 2=6 681.34, P <0.01) and obesity ( χ 2=15 663.08, P <0.01) were higher in male than in female. The prevalence of overweight and obesity in urban students was higher than that in suburban students (29.55%,27.95%; χ 2=211.43, P < 0.01 ), the prevalence of obesity in urban students was higher than that in suburban students from 2009 to 2013, and the prevalence of obesity in suburban students was higher than that in urban students from 2014 to 2018. The districts and counties with the highest detection rates of overweight and obesity are Shijingshan District (overweight: 19.06%, obesity: 13.99%), and the districts and counties with the lowest detection rates of overweight and obesity are Yanqing District (overweight: 13.48%, obesity: 7.18%). Conclusion From 2009 to 2018, the prevalence of overweight and obesity among high school seniors in Beijing has been increasing by year, and tends to be stable after 2016. Significant upward trend in obesity prevalence in suburban areas of Beijing has been observed.

Objective: To understand the prevalence of hyperuricemia in university students and examine associated factors,and to provide evidence for the prevention and treatment of hyperuricemia. Methods: Health examination data of 11 858 students for admission in October 2021 were used to compare the detection rates between groups with different characteristics. Multivariable Logistic regression was performed to identify potential factors associated with hyperuricemia. Results: A total of 3 372 cases of hyperuricemia were found, with a detection rate of 28.4%. The detection rate of male students was significantly higher than that of female students (42.4%,14.6%). The rate increased with higher BMI. Moreover, the detection rate was higher among undergraduates and those with hypertension( χ 2=1 126.2, 180.7, 138.2 ,107.9, P <0.01). Multivariable Logistic regression analysis showed that male sex, younger age, higher BMI, hypertension and higher hemoglobin level were positively associated with hyperuricemia, whereas higher glomerular filtration rate was negatively associated among the students( P <0.01). Conclusion Greater attention should be given to hyperuricemia in university students, and targeted health education should be strengthened for them, especially undergraduates, boys, overweight and obese students, and those with hypertension or high hemoglobin levels.

To compare the performance of generalized additive model (GAM) and long short-term memory recurrent neural network (LSTM-RNN) on the prediction of daily admissions of respiratory diseases with comorbid diabetes. Daily data on air pollutants, meteorological factors and hospital admissions for respiratory diseases from Jan 1st, 2014 to Dec 31st, 2019 in Beijing were collected. LSTM-RNN was used to predict the daily admissions of respiratory diseases with comorbid diabetes, and the results were compared with those of GAM. The evaluation indexes were calculated by five-fold cross validation. Compared with the GAM, the prediction errors of LSTM-RNN were significantly lower [root mean squared error (RMSE): 21.21±3.30 vs. 46.13±7.60, <0.01; mean absolute error (MAE): 14.64±1.99 vs. 36.08±6.20, <0.01], and the value was significantly higher (0.79±0.06 vs. 0.57±0.12, <0.01). In gender stratification, RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting female admission (all <0.05), but there were no significant difference in predicting male admission between two models (all >0.05). In seasonal stratification, RMSE and MAE of LSTM-RNN were lower than those of GAM in predicting warm season admission (all <0.05), but there was no significant difference in value (>0.05). There were no significant difference in RMSE, MAE and between the two models in predicting cold season admission (all >0.05). In the stratification of functional areas, the RMSE, MAE and values of LSTM-RNN were better than those of GAM in predicting core area admission (all <0.05). has lower prediction errors and better fitting than the GAM, which can provide scientific basis for precise allocation of medical resources in polluted weather in advance.
Beijing/epidemiology* ; Diabetes Mellitus/epidemiology* ; Female ; Hospitalization ; Humans ; Male ; Memory, Short-Term ; Neural Networks, Computer

Objective:To analyze the competence assessment examinations of registered dietitians in China during 2017-2021 to inform the training of dietetic professionals.Methods:A systematic review was conducted about the composition and changing trends of examination participants during 2017-2021. Participants were divided into subgroups based on gender, age, education, professional background and affiliations and the qualification rate was compared across different subgroups.Results:The number of examination participants showed an increasing trend overall, with the majority being females and aged 26-35 years. The ratio of participants with bachelor's: master's: doctor's degree was about 15: 9: 1. The proportion of participants majoring in nutrition science decreased from 32.1% to 20.3%, while that of participants majoring in other medical and food sciences increased. Among participants from healthcare institutions, a decreasing proportion of participants were with a major in nutrition science, while this proportion among participants from companies were stable at 38.8% to 50.2%. The average qualification rate was 35.7%, showing no significant differences among different gender and age groups. But the qualification rate varied significantly across subgroups with different education level, professional background, and affiliations ( P < 0.05). Subgroups with more advanced degrees showed higher qualification rate and the best rate was observed in the subgroups with professional background in nutrition science and from nutrition-related institutions. Conclusion:The training of dietetic professionals in China should be improved, lifelong learning should be promoted in nutrition practitioners, and the sustainable development of dietitians should be impelled.

Objective To investigate the prevalence of thyroid nodules in women participating in physical examination in Beijing and analyze the influencing factors. Methods The data of physical examination (height, weight, blood pressure, blood glucose, etc.) and questionnaire survey (activity intensity, eating habits, etc.) of women in Beijing in 2016 were collected, and the influencing factors of thyroid nodules were analyzed by multivariate logistic regression. Results A total of 4 732 women were included in this study. The prevalence of thyroid nodules was 49.6%. Multivariate logistic regression analysis showed that compared with women aged 18-29 years, OR value was 1.769 (95% CI =1.489 ~ 2.102) for women aged 30 ~ 59 years, and OR value was 4.716 (95% CI = 3.577- 6.216) for women aged 60 years and over. Compared with the balanced diet, the OR value was1.237（95%CI=1.056-1.450）for vegetarian diet. Compared with the normal weight, the OR value was 1.331（95%CI=1.153-1.537）for the overweight. Compared with the healthy women, the OR value was 1.405 （95%CI=1.146-1.723）for hypertension, the OR value was 1.184（95%CI=1.040-1.347）for hyperlipidemia, and the OR value was 1.779（95%CI=1.178-2.687）for diabetes, while the OR value was 1.183（95%CI=1.018-1.376）for women with mammary gland nodules, and the OR value was 1.376（95%CI=1.201-1.575）for women with uterine leiomyoma. Compared with the education degree of high school, technical secondary school, technical school and below, the OR value was 0.648（95%CI=0.522-0.806）for college or undergraduate, and the OR value was 0.564（95%CI=0.440-0.723）for graduate students and above. Conclusion The prevalence of thyroid nodules in women in Beijing is at a high level. Age, vegetarian diet, overweight, hypertension, hyperlipidemia, diabetes, mammary gland nodules and uterine leiomyoma are risk factors for thyroid nodules. Education level is a protective factor for the prevalence of thyroid nodules.